When I found out I was pregnant with Leah, I hadn’t even thought about what kind of birth I wanted to have. To be honest, we had barely adjusted to the idea of trying to GET pregnant. Of course, Joshua and I had always talked about wanting to have children someday. And when we were finished with school, settled into our new home, and both had stable jobs, the time seemed right to start trying. But I don’t think either of us expected a positive pregnancy test less than a month after we made that decision!
In those early weeks, I was afraid to get too excited. So many people I’m close to have lost their babies early in their pregnancies. Making too many plans for a birth nine months in the future felt like tempting fate. It was hard not to worry, but eventually I came to terms with the fact that I truly had no control over the outcome of this pregnancy. All I could do was make the healthiest decisions I could to nurture this new life growing inside me, and leave the rest in God’s hands. I thanked Him every morning for the blessing of getting to carry my baby that day, regardless of what might happen tomorrow.
But around halfway through the pregnancy, with a newly bulging belly and ever stronger kicks reminding me that I was never alone, I could no longer ignore the fact that soon, this little lady would need to make her entrance to the world. I began reading some books about natural childbirth. And the more I learned, the more I felt that this was the right decision for my baby and myself. When I met her for the first time, I didn’t want my mind dulled with any pain medication. I wanted to be fully present for the whole experience. I didn’t want any medications in her tiny body that might make the birth process harder on her, or affect her ability to be fully alert to nurse and bond with her Daddy and me when she arrived. So I began making plans for a natural birth.
Many people who make this decision hire a midwife instead of an obstetrician. Midwives have lots of experience with normal births, which can often happen in the comfort of home, while obstetricians are trained to handle high risk deliveries where life-saving medical interventions are necessary. These interventions are wonderful in births where they are actually needed, but they are sometimes overused in normal births, leading to unnecessary surgeries and drugs for the mother and the child. If I had another baby, I thought I might like to try the midwife route. But I did not want to switch care providers so late in this pregnancy. So I stayed with Dr. Sick, the obstetrician I’d been seeing since I got pregnant with Leah, and decided to hire a doula, Nicolle, to help support me in achieving as natural a birth as I could in the hospital.
My plan was to labor as long as I could at home. In a typical labor, contractions start mild and short with lots of time to rest in between. I had read birth stories of couples going out to a restaurant for one last meal together while the wife was in early labor! I thought that sounded great. Stay at home as long as I could cope, and when contractions began getting longer and closer together, we would go to the hospital and hopefully have a baby very quickly.
But Leah had other ideas about how she wanted to make her arrival. I was so excited when I reached 37 weeks of pregnancy, when a baby is considered at term and can safely arrive at any time. I had many friends who had their babies this early, or shortly thereafter. So I waited expectantly, wondering each night if this would be the night I went into labor. I did everything the books recommended to naturally prepare my body for labor – eating six dates a day, drinking red raspberry leaf tea, continuing to run, eating spicy foods, getting massages, you name it. And I woke up each morning to find that I was still very pregnant… through week 38… and week 39… and week 40.
It turns out that this is the time obstetricians like to talk about induction. In a healthy pregnancy, it can be normal and safe for babies to be delivered at 42 weeks and beyond. However, there is a small but significant increase in the percentage of stillborn babies after 42 weeks. So the current medical recommmendation in the United States is not to allow pregnancies to go beyond this point.
An induction involves administering medications to soften the cervix, if necessary, and then giving synthetic oxytocin which forces the uterus to have very strong, close contractions, which are often much more painful and put the baby under more stress than regular contractions. Most women need an epidural to cope with the pain of a pitocin-induced labor. Sometimes, despite all of this, inductions can fail and result in the need for a C-section.
I really, really did not want to have to induce. But I also didn’t want to put my baby at risk by keeping her inside too long, even though I knew the risk was very small. So I consented to an induction on the Thursday that I would reach 41 weeks 5 days, if she did not make her appearance before then.
Week 41 came and went, and I became more and more anxious as the induction day approached. If you’ve heard of any natural methods of inducing labor, chances are, I tried it. But there was one thing I hadn’t tried. Its use is a little controversial because it doesn’t always work to induce labor, but chances are good it will cause the mother to become nauseated, dehydrated, and exhausted. For the baby, though, there are far fewer documented risks than those of medical inductions. So on the Sunday of my induction week, I decided it would be worth it to plan to stay home all day and give it a try.
I got up Sunday morning, had a good breakfast, and drank a big bottle of electrolyte drink. Then I went for my usual mile walk that I tried to get in on non-running days. Finally, at 8:00am, I made a castor oil smoothie… which was about as delicious as it sounds. I got it all down though, and then waited to see if anything would happen.
A couple hours later, the diarrhea started. I pretty much had to camp out in the bathroom. But in addition to the expected diarrhea cramps, I was beginning to experience some cramping in my abdomen and lower back that was more rhythmic. In fact, it was happening every 2-3 minutes. Surely this wasn’t early labor? From everything I had read, early labor contractions happened much further apart and were fairly mild – these HURT! I sat on a heating pad to help ease the pain.
Then, during one of my bathroom trips, I found something that looked suspiciously like part of my mucus plug. It was bloody, and up until this point, I’d had no bleeding for the entire pregnancy. I continued to find more of this bloody discharge… and then, some fluid that had a greenish tinge. Was this just more mucus plug, or something else? I was worried that my water may have broken – it doesn’t always come out in a huge gush like in the movies, but sometimes is just a slow trickle. And a green color can mean that the baby has passed meconium, which can be a sign of fetal distress. I called Nicolle, my doula, and we decided that the safest thing would be to head to the hospital to get the fluid checked and make sure the baby was okay.
As Joshua drove me to the hospital, the cramping continued to happen every 2-3 minutes. The car ride was extremely uncomfortable – bumpy roads just made the pain more intense. Finally, we arrived in triage, where they had me lie down in a bed and get hooked up to a monitor that asssessed the baby’s heart rate and the strength of my contractions. And yes, that is definitely what the cramps were. These weren’t little cramps that I could ignore – I had to focus on breathing deeply through each contraction. And thanks to the castor oil, I was still having to get up and make frequent trips to the triage bathroom. This certainly wasn’t the happy, carefree beginning to labor that I had imagined. But as hard as it was, I was thankful that I was here getting ready to have my baby instead of waiting to be induced on Thursday. And maybe since my contractions are so close together, I reasoned hopefully, that means I’ll end up having a short labor!
They tested the fluid and found that it was not amniotic fluid, but actually was part of my mucus plug. They checked my cervix, which was extremely uncomfortable and set off more contractions. (I will mention here that I requested in my birth plan not to be informed of my dilation or effacement, because these numbers only represent a snapshot in time that can change quickly, and I didn’t want to be discouraged in my laboring if the numbers were lower than expected. But I will include the numbers as I found them out later from discussions with Joshua and Nicolle.) I was only 1-cm dilated and 50% effaced, which indicated very early labor – these numbers actually weren’t any different than they were at my last routine visit with Dr. Sick. But because my contractions were so frequent, they decided to keep me in the hospital.
I was wheeled to a large, quiet hospital room which was immensely more comfortable than triage. It even had a whirlpool tub in the bathroom! I was allowed to have intermittent monitoring – 30 minutes with the fetal monitor on, and 30 minutes off when I was free to move around the room and even walk the hospital halls. Nicolle arrived shortly and encouraged me to do just that – stay as active as possible to help encourage my cervix to dilate and the baby to descend. We enjoyed walking and conversing, stopping every few minutes so I could lean against the wall and sway through a contraction.
Back in the room, when I was attached to the monitor, we continued to try different positions such as sitting on my birth ball, lying on my side with the peanut ball, or even standing and swaying while leaning against Joshua, which made for some especially precious and intimate moments even with the pain. I was so thankful that I was free to labor in different positions instead of having to lie on my back, which is how you always see people laboring in movies, but for me was the most uncomfortable position of all to deal with a contraction.
I knew my dreams of a quick birth were not going to happen when Nicolle announced after a cervical check that she would be going home to sleep that night and returning in the morning to help me through the rest of my labor. Joshua and I stayed up awhile longer. During one of my breaks from the monitors, he filled up the whirlpool tub for me. The heat and massage felt great during contractions. But all too soon, it was time to get out and put the monitors back on.
Finally we decided to lie down in bed and try to get what little sleep we could. The contractions continued to get more intense, and never spread more than 5 minutes apart. At this point, in addition to my breathing techniques, I needed pressure on my lower back to help me get through them. I would doze off, then a contraction would rudely wake me up, and I would elbow Joshua awake to give me the pressure I needed. I began quietly moaning to help me manage the intensity of the contractions. I felt they were harder to deal with when I was asleep, because I was never able to get ahead of them when they first started – by the time they woke me up, they were already reaching their highest intensity. This strange state of half-consciousness continued through the night.
I did not like the overnight nurse. She kept coming in and telling me “The baby doesn’t like that side” and I needed to roll over onto my other side. I think the monitors were just having issues. At one point, she was concerned about Leah’s heart rate getting too low, and she started me on IV fluids and had me wear an oxygen mask. Thankfully I didn’t need these for long – they determined her umbilical cord had been in a strange position where it was getting compressed every time I had a contraction, and her heart rate issues resolved once she changed positions. I got sick a couple times, which apparently is pretty common during labor. The nurse asked me if I wanted something for the nausea, and I sleepily accepted. She didn’t tell me until after she’d given me an IV dose of phenergan that it would make me very dizzy, and I shouldn’t get out of bed until the effects wore off. And not long after the medication was given, I got sick again anyway!
Finally morning came, the phenergan wore off, and Nicolle returned. I immediately felt more comfortable with her there. She was able to relieve Joshua of his duty of putting pressure on my back, which I really needed right now to get through each progressively more intense contraction. At some point, our amazing birth photographer Whitney arrived and began capturing moments that would otherwise have just been a labor blur to me.
I allowed myself to become more vocal, moaning more loudly in concert with the intensity of the contraction. I was careful not to allow these sounds to become shrill or fearful, which can actually inhibit the progression of labor. I imagined myself as a lion roaring powerfully, although in reality I probably sounded more like a cow! For a few contractions, I squirmed into different positions to try to find one that would lessen the pain. This didn’t work, and trying to escape the pain just made me more anxious. The mental strategy that ended up helping me the most was reminding myself that the only way out of the pain was to work through it. And work through it I did – roaring/mooing as loudly as I needed to at the peak of each contraction, then enjoying the short breaks that allowed me to recover for the next one.
Nicolle continued encouraging me to try different positions. Some worked better than others. My favorites were the ones where I could be close to Joshua, Having him hold me through the most difficult moments I’d ever been through is one of my favorite memories of this birth. He handled it like a champ, showing his support and love through this whole ultramarathon of labor, even when I was yelling at the top of my lungs in his ear!
At some point in the morning, Dr. Sick decided it would be a good idea to break my water to encourage labor to progress a little more quickly. A few hours later, she still wasn’t happy with the speed at which I was progressing. (I found out later that my labor had stalled at 9-cm, and there was a small cervical lip preventing my cervix from dilating all the way.) We tried using a breast pump to stimulate my nipples, which releases oxytocin and can help increase the strength of contractions. But that wasn’t enough to get me dilated all the way.
Finally we decided that the best thing to help my labor progress would be to give me a low dose of Pitocin. Throughout my labor so far, I had not been scared. The process was very intense, but it was an intensity generated by my own body that, though challenging, I knew I could deal with. I’d heard so many scary things about Pitocin, and everyone said that contractions hurt a lot more when it was on board. Many people couldn’t handle the pain without an epidural. When they started the Pitocin drip, that was the closest I ever got to experiencing fear… not for myself or for Leah, but that I wouldn’t be able to do this without drugs. I expressed my fears to Joshua and Nicolle, and they both reassured me that I could do this. I focused on getting through one contraction at a time, yelling even louder than I’d been yelling before, and wondering how much more of this I could take. This was definitely the most intense part of labor, but it was thankfully very short. The Pitocin had done the trick, and before I knew it, they said that I was fully dilated and could start pushing!
Many people say that pushing is the best part of labor, because finally you get to do something instead of just managing your pain through each contraction. Personally, I did not enjoy it. I kept thinking about the fact that I hadn’t had anything to eat since breakfast yesterday, and it was almost dinnertime. I wouldn’t run a marathon without fueling, and here I was expected to push a baby out of my body. I hoped I would be able to do it.
At first they tried having me push on my side. But the doctor kept inserting her finger to feel the baby’s head while I was pushing, and it felt very unnatural to me to push while I was being examined in this way. I did not make much progress in the side-lying position – whether because of the position or because of the constant examinations, I don’t know. But they finally had me try the lithotomy position – the typical lying-back-in-the-bed that you see in movies. This is actually supposed to be one of the least effective positions for pushing, and one of the most likely positions to tear. I knew all this, but I was too tired to argue. I finally did request that the doctor remove her finger and let me try pushing without it. Nicolle held a scarf that I pulled against while I pushed – waiting for the peak of a contraction… then holding my breath and pushing as hard as I could for the count of ten… then taking a quick breath and repeating the process two more times before recovering my breath and waiting for another contraction. And after a couple pushes in the new position, Dr. Sick said that the baby was moving down the birth canal.
After some more pushing, they announced that they could see her head, and I got to reach down and feel her! It was such a surreal moment, touching my baby who was so close to emerging into the world. Someone got me a mirror which allowed me to watch her crowning. Pushing was a little more tolerable now that I could see my progress. At one point, Dr. Sick commented on how much hair she had, and stroked her little head. The head responded by popping quickly back inside. Joshua and I both adamantly requested that there be no more head stroking!
Some people describe crowning as one of the most painful parts of labor, giving it such descriptive names as the “ring of fire.” For me, it wasn’t that bad… it just felt like a tingling, stretching sensation. This allowed me to push her out slowly enough to keep tearing to a minimum. Each time I pushed, the crown of her head that was visible grew a little larger. And finally, after about 2 hours of pushing, the big moment came – I gave the biggest push I could muster, and out popped her head, with the rest of her body sliding easily behind!
No words can describe the relief I felt at this moment, after what ended up being 30 hours of labor without a drop of pain medication. No words can describe the emotions that flooded me when someone said, “Look at your baby!” and I looked up and saw her face for the first time. She came out pink and screaming at the top of her lungs, and I thought those screams were the most beautiful sound I ever heard. There did end up being some meconium in her amniotic fluid, so they needed to spend some extra time suctioning all the fluid out to make sure it didn’t get into her lungs. But they didn’t take her away before letting me hold her a moment. Who would have thought that I could have such love for this wet, pruney little being that they laid on my chest? I was bawling happy tears.
They were able to do all her necessary care in the room by my bed, and soon she was back on my chest. I had sustained a first degree tear and was getting stitches, but I didn’t care. The pain was nothing compared to what I had just endured, and I was joyously distracted by the sweet little person in my arms.
There would be a lot of challenging moments over the next few weeks as Joshua and I figured out how to be parents. But for that moment, everything was perfect. Snuggling with our daughter, looking into her eyes, wondering at every perfect little part of her.
I’ve run a lot of races and crossed a lot of finish lines. But no ultramarathon will ever match the intensity of the race I had just run. And no finish line prize could ever compare with the beautiful child I now held in my arms. My birth plan didn’t happen exactly the way I wanted it to, but thanks to Nicolle, Joshua, and a very supportive obstetritician, it was pretty close.
The experience made me realize anew how blessed I am to have such a wonderful husband, and now I had a wonderful daughter too. We were a family! And as I held little Leah close, I decided that of all my life accomplishments – marathons, academic achievements, college degrees, my veterinary career – this was the one I was the most proud of.